CN102883679A - Minimally invasive sling for the surgical treatment of female urinary stress incontinence - Google Patents

Minimally invasive sling for the surgical treatment of female urinary stress incontinence Download PDF

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Publication number
CN102883679A
CN102883679A CN2011800200591A CN201180020059A CN102883679A CN 102883679 A CN102883679 A CN 102883679A CN 2011800200591 A CN2011800200591 A CN 2011800200591A CN 201180020059 A CN201180020059 A CN 201180020059A CN 102883679 A CN102883679 A CN 102883679A
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sling
grid
preferred
scopes
aforementioned
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CN2011800200591A
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CN102883679B (en
Inventor
皮尔·阿尔多·克雷帕尔迪
罗伯塔·拉姆贝提
多纳特·皮罗利托雷利
埃尔曼诺·特拉布科
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He Niman Executes Co Ltd
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He Niman Executes Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/0036Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable
    • A61F2/0045Support slings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0015Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in density or specific weight
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0023Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in porosity

Abstract

The sling is intended to support the urethra and comprises an oblong median portion (10) and anchoring end portions (12). A first mesh (18) of synthetic, biocompatible, non-absorbable polymer extends from one end portion (12) to the other through the median portion (10). A second mesh (20) of synthetic, biocompatible, non-absorbable polymer having average porosity lower than the average porosity of the first mesh (18), but nevertheless greater than 100 [mu]m, is joined to and superimposed on the parts of the first mesh (18) belonging to the end portions (12).

Description

The minimally-invasive sling that is used for the surgical treatment of female stress incontinence
The present invention relates to be used for the treatment of the device of urinary incontinence, urinary incontinence is a kind of major effect women's common pathological changes.Estimation has surpassed 1,300 ten thousand people in the U.S. and has suffered from urinary incontinence, and their 85% are the women.About the sickness rate from urinary incontinence among the women of four different European countries (France, Germany, Spain and Britain), 35% the women who is interviewed is ready to be provided at the answer of the non-active discharge of urine in front 30 days of the access.The type of urinary incontinence mainly is stress incontinence (S.Hunskaar et al-Theprevalence of urinary incontinence in women in four European countries-BJUInternational, Volume 93 Issue 3, Pages 324-330, published online:4Feb2004).I type and II type stress incontinence per urethram hyperkinesia (urethral hypermobility) cause, the urethra hyperkinesia is that a kind of wherein pelvic floor weakens or damages, and causes weakening the disease of the reaction that neck of bladder and/or contiguous urethra increase intra-abdominal pressure.This pressure can be because the daily routines of various routines, as laugh at, sneeze, cough, carry heavily, walking or stand from the seat.The result is the unsuitable reaction of the sphincter of urethra, and the result urinates loss.Can cause that hyperkinetic biological factor comprises muscle tonus degree in the inadequate pelvis (because ageing or limited physical exertion), damage the stretching that causes by fascia intrapelvina, since conceived, for example, muscle separates with ligament (fascia and arcus tendineus), or hormone (estrogen) lacks.
In order to increase UCP, thereby reduce the non-active discharge of urine, provide support under urethra by operation method.
Need to implant the material that is called " sling " in the position of urethra bottom for the most normally used operative treatment of women's stress incontinence at present.Conventional, under urethra, insert sling in order to provide and bear and keep face, when sphincter of urethra suffers oppression, to limit as much as possible the sagging of muscle in the pelvis.Complexity and technical difficulty about the operation method of the anatomical position of sling have problem sometimes for operative doctor and patient.Certain methods that be used for to implant urethral support needs a plurality of otch of patient body, and in some cases, and sling is also from patient's external tension after the operation.
Yet, for a lot of slings that other are implanted usually, need to be by screwing or sew up its installation or being fixed to skeleton, tissue, skin or muscle.In fact, any ad hoc approach that does not need to provide tension or sling is installed to be reaching restraining, because urethra is stable by sling itself and keep, but passes through the reaction in the hole of sling by the tissue fibers growth.Fibrotic process promotes that sling is attached to contiguous tissue, and this is basis (the D.PiroliTorelli et al.-SUS for the correction of stress urinary incontinence:towardsmore and more simplified surgery-Urogynaecologia International Journal2008 without the suspension apparatus that uses in the tension force method; 22; 8:5-15).
In fact, without the trans vagina suspender of tension force TVT(art (trans-vaginal tape)) or TOT(through closed pore suspender art (trans-obturator tape)) operation method is the most frequently used, even although in these cases, also need the insertion of a plurality of otch and device also must use the insertion pin.It is long that sling can reach 45cm usually: therefore the not direct excess material relevant with urethral support extended by stomach wall in the situation of TVT method, or in the situation of TOT method, extend by closed pore, and stay permanent implantation, become the possible source of infection and cause lifelong uncomfortable of patient.
During pin passes, can elicitation technique problem and serious complication.For example, the typical complication of some of TVT method comprises possible vesical perforation (needing cystoscopy), intestinal perforation, nerve and blood vessel injury, this blood vessel injury may cause in the operation hemorrhage, and dead (DanielRapoport, MD, Howard N.Fenster, MD, Jamie E.Wright, MD-Reportedcomplications of tension-free vaginal tape procedures:A review-BCMJ, Vol.49, No.9, November 2007, page (s) 465-524).
The TOT method also can cause potential complication: these comprise hemorrhage in the operation of patient's chance, pain and uncomfortable, infection, hemorrhage and postoperative urethral obstruction.(Neuman?M.-TVT-Obturator:Short-term?data?on?an?operative?procedure?for?the?cure?offemale?stress?urinary?incontinence?performed?on?300patients-Eur?Urol?2007;51:1083-1087;Rezapour?M,Novara?G,Meier?PA?et?al.-A?three-monthpre-clinical?trial?to?assess?the?performance?of?a?new?TVT-like?mesh?(TVTx)ina?sheep?model-Int?Urogynecol?J?Pelvic?Floor?Dysfunc?2007;18:183-187)。The pain that produces in groin and seat area is the result of dorsosacral position lithotomy position (cutting the stone position) (two lower limbs are far apart), and the patient must take dorsosacral position lithotomy position (cutting the stone position) better to arrive closed pore at intra-operative; Suffer from the situation that coxarthropathy or function of joint go down in the women, this complication becomes more serious.
Existing document WO 2008/067317 has been described the sling that comprises the rectangle middle part and be used for being fixed to the end of tissue, and wherein sling is Operation.The middle part is made by biocompatible polymer grid, and links to each other with the bioresorbable polymer end with sawtooth or pointed projection.The end is sizable, thereby is invasive for the tissue that they will be implanted, therefore be by the bioresorbable polymer make so that they can disappear in time.
WO2005/122954 offered in existing of another piece of writing, described the sling that is formed by grid, and its end folds back himself to be formed for connecting the respective bag of instrument, is used for the device of bad seek stomach wall perforation.
US-2005/0267325 has described general implantable operation object, and relates generally to the method for the layer that engages different materials or same material.The sling that comprises the first grid with end has been shown among the US-2005/0267325, and the two sides of this end is covered by the second grid of corresponding Y shape, and the branch of Y is contiguous with the respective face of the end that links to each other of the first grid, and the stem of Y forms the respective end of sling.Thereby first grid do not extend to another from an end of sling.Fixedly pass perforate perpendicular to the general layout of sling by corresponding polymer, two parts of Y shape the second grid are connected to the first grid, in order to realize this, typically must carry out daily (ad hoc) process, and it can promote the formation in space in the grid.It should be noted that this structure has three layers that connect by fixing (rivet), in US-2005/0267325, described it and made the terminal hard of sling and become large essence.
US-2002/0028980 has described the implantable object that comprises base section, and extend independently of one another from an end of implantable object two coupling parts.This object has the shape of Y shape, in other words unsound shape.In addition, US-2002/0028980 has stated that simply the object of describing therein can comprise, in unrestriced mode, hole with the size in 1.016 to the 1.397mm scopes, do not mention average-size or have in addition the probability in the hole of different size, and only illustrated that the selection of the size in hole is to be determined by the consideration relevant with being mounted to surrounding tissue.
Therefore the purpose of this invention is to provide the improved device of prior art, especially, it does not have above-mentioned shortcoming and can be used for better simply and safer operation technique.
According to the present invention, reach this purpose by the sling that comprises rectangular middle part and anchor portion, that this sling has is synthetic, biocompatible, the first grid of the polymer of nonabsorable, it extends to another by the middle part from an end, and the second grid of the polymer of synthetic, biocompatible, nonabsorable, yet it has the average pore that is lower than the first grid greater than the average pore of 100 μ m, this second Mesh connection to and be superimposed on the part that the first grid belongs to the end.
In this description, term " average pore of grid " expression, especially, and the arithmetic mean of instantaneous value of the size in the hole between the fibril, it is by the situation of braiding and type decided.
Therefore sling according to the present invention with the first grid (as in italian patent MI2009A001186, describing, its content is integrated with herein by reference) combine with the second grid, this first grid has elasticity and the high axial rift load of high porosity, reduction, this the second grid ends vulcanized, and still kept to a certain extent elasticity and macroporosity.Macroporosity is the determinant attribute according to sling of the present invention because it not only promotes fibroblast to infiltrate, fibroblast is infiltrated be firm and permanent fixing (anchorage) institute based on key element, and make initial any infection reduce to minimum.This is because antibacterial can be invaded all operation grids, because their average diameter is about 1 μ m, if to such an extent as to and the enough large infiltrations that allows macrophage of the hole of grid, this macrophage is the immunocyte of about 10 μ m sizes, it is responsible for engulfing antibacterial, and infection then can be on the defensive.Because greater than 100 μ m, as indicated above, sling has so that the advantage that macrophage and fibroblast are infiltrated according to the average pore of the end of sling of the present invention.
In periurethral connective tissue, provide strong connection by ends vulcanized, fixedly occur in instantaneous postoperative period.Helping to keep sling another factor in position is that it is subjected to two kinds of opposite pressure, one from outside to inside, and per vaginam the fascia of mucosa and bottom (fascia) produces, and another from the inside to the outside, it is produced by intra-abdominal pressure, both in the effect enclosed space anatomically.The location of sling, it is not attached to obturator membrane with fixing position, thereby in fact can be described as " tension-free ".Rear several hours of operation is infiltrated the hole of sling by the fibrous tissue of new one-tenth, and it also helps to fix.
Because its specific structure, can be shorter than the total length of similar known devices according to the total length of sling of the present invention, the length of these known devices causes passes film.On the contrary, be about 66mm according to the length of sling of the present invention, thereby before allowing closed pore (pre-obturator) along the direction location identical with the TOT sling of above-mentioned prior art.
See that on the whole sling according to the present invention provides the xenobiotics of remarkable less amount to inserting wherein health, but it still can be with suitable implanting with nonvolatil mode.
And sling according to the present invention makes it possible to use the operation method of useful " single otch ", thus with operating theater instruments pass through reduce to minimum, also risk and the postoperative pain in the restriction operation simultaneously.
With reference to the accompanying drawings, the mode by non-limiting example has provided following detailed description, and other advantages of the present invention and characteristic will become clear, wherein:
Fig. 1 is the plane graph according to sling of the present invention, and
Fig. 2 is the side view of the sling of Fig. 1.
Comprise rectangular middle part 10 and anchor portion 12 for the sling of keeping urethra.For the purpose that defines, as clearly illustrating in the accompanying drawings, end 12 comprises the farthest zone of excentric sling necessarily.
The middle part has common conical in shape from the center to end, it is to be formed by the central part 14 at basic right angle and substantially trapezoidal end 16 especially, the periphery of this central part 14 is formed by pair of short edges and a pair of long limit, and the base that this end 16 is grown is relative with the minor face of central part.
Each end 12 is substantially sagittate, its tip outwardly, the width of the bottom of each arrow is greater than the Breadth Maximum at middle part 10.
The first grid 18 extends to another end 12 from an end 12, by whole middle part 10.Having corresponding the second grid 20 less than the average pore of the first grid 18 is superimposed on the whole extension that the first grid 18 belongs to end 12.Two kinds of grids 18 and 20 are connected to each other on whole contact surface continuously, for example by any other method in welding or suture or the hole by not blocking them, preferably pass through ultra-sonic welded.
Thereby grid 18 is to connect in the situation such as extra a large amount of key elements of fixing (rivet) etc., fixedly waiting and will harden sling and make its heaviness, and provide fine and close structure to sling by this way with being connected.
Shall also be noted that such as Fig. 2 to clearly illustrate that the second grid 20 only covers the one side of each end of the first grid 18, generally speaking the first grid 18 overlaps with the end 12 of sling, and the opposite of the end of the first grid 18 is not capped.
See that on the whole the relative longitudinal axis 22 of sling and the transverse axis 24 that is positioned at its general layout are symmetrical, and are made of grid 18 and 20.
Useful, the first grid 18 has 30 to 60g/m 2Nominal density, preferred 48g/m 2, and the average pore in 800 μ m to 1200 mu m ranges, preferred 1000 μ m, and the second grid 20 has 100 to 160g/m 2Nominal density in the scope, preferred 127g/m 2, and the average pore in 500 μ m to 900 mu m ranges, preferred 700 μ m.
The first and second grids 18 and 20 can be independently formed by the fibril of the biocompatibility synthetic polymer of any nonabsorable, for example are selected from the polymer in the group that homopolymer and copolymer by polypropylene, polyethylene, polyester, polyamide, polymer of partly or entirely fluoridizing and composition thereof form.If keep above-mentioned porous parameter, grid 18 and 20 fibril also can cover any biocompatible materials (no matter whether biology can be resorbent).Especially, grid 18 can be made by the PP monofilament of 80 μ m, and grid 20 can be made by the PP monofilament of 180 μ m.
For instance, sling can have the total length " a " in 55 to the 75mm scopes, preferred 66mm, and each end 12 can have the length " d " in 5 to the 15mm scopes, preferred 8.5mm.
Also by way of example explanation, the short base of each end 16 at middle part 10 can have the length " f " in 5 to the 9mm scopes, preferred 6.5mm, and each long limit can have the length " e " in 10 to the 40mm scopes, preferred 21mm, and each minor face can have the length " b " in 9 to the 12mm scopes, preferred 11mm.
Useful, each flechette-type end 12 has the width on the base " c " in 11 to the 16mm scopes, preferred 13.5mm, and the drift angle " h " in 75 ° to 105 ° scopes, preferred 90 °.See that on the whole each arrow is shaped with the shape of equilateral triangle and fillet " g ".
In a preferred embodiment, the thickness at middle part 10 " m " in 0.25 to 0.35mm scope, preferred 0.3mm, and because grid 18 and 20 overlapping, the thickness of end 12 " n " in 0.4 to 0.6mm scope, preferred 0.5mm.
Operation for the sling of above-described type, begin to form the length of the about 1cm of suburethral vaginal incision, the two passes that the right and the left side of urethra is formed about 3.5cm length after this, according to the approach that uses in the TOT method, until do not contacting with the obturator membrane generation in the situation that it is passed.Then the end 12 with a flechette-type folds self, and clamps with crooked Klemmer mosquito forceps, so that it can insert in the first amenorrhea hole path.Then identical operation is carried out to be inserted in the second channel in another end 12.
At last, carry out colporrhaphy with one or two independent interior bending (introflecting) sutures at the otch of vagina.
Certainly, in the situation of the scope of the present invention that in not deviating from such as the claim of enclosing, limits, that principle of the present invention keeps is identical, describes for those that have provided fully by way of example, can extensively change the detailed description of structure and the form of embodiment.

Claims (15)

1. be used for keeping the sling of urethra, comprise rectangular middle part (10) and anchor portion (12), it is characterized in that, synthesize, biocompatible, first grid (18) of the polymer of nonabsorable extends to another end (12) by described middle part (10) from an end (12), synthesize, biocompatible, second grid (20) of the polymer of nonabsorable have be lower than described the first grid (18) however average pore greater than the average pore of 100 μ m, described the second Mesh connection to and be superimposed on the part of described the first grid (18) that belongs to described end (12).
2. sling according to claim 1, wherein, described the first grid (18) has 30 to 60g/m 2Nominal density in the scope, preferred 48g/m 2, and the average pore in 800 to 1200 mu m ranges, preferred 1000 μ m.
3. sling according to claim 1 and 2, wherein, described the second grid (20) has 100 to 160g/m 2Nominal density in the scope, preferred 127g/m 2, and the average pore in 500 to 900 mu m ranges, preferred 700 μ m.
4. according to each described sling in the aforementioned claim, wherein, the thickness of described middle part (10) in 0.25 to 0.35mm scope, preferred 0.3mm, and the thickness of described end (12) is in 0.4 to 0.6mm scope, preferred 0.5mm.
5. according to each described sling in the aforementioned claim, wherein, described the second grid (20) is connected to described the first grid (18) in the gamut of described end (12), preferably by welding or stitching, passes through especially ultra-sonic welded.
6. according to each described sling in the aforementioned claim, have the total length in 55 to the 75mm scopes, preferred 66mm, each end (12) have the length in 5 to the 15mm scopes, preferred 8.5mm.
7. according to each described sling in the aforementioned claim, wherein, described middle part (10) have the taper from the center to end usually.
8. sling according to claim 7, wherein, described middle part (10) is to form by the central part (14) at basic right angle and by end (16), the periphery of described central part (14) is formed by pair of short edges and a pair of long limit, described end (16) has substantially trapezoidal shape, and the long base of described end (16) is relative with the described minor face of described central part (14).
9. sling according to claim 8, wherein, the short base of each end (16) of described middle part (10) has the length in 5 to the 9mm scopes, preferred 6.5mm.
10. according to claim 8 or 9 described slings, wherein, each long limit has the length in 10 to the 40mm scopes, preferred 21mm, and each short limit has the length in 9 to the 12mm scopes, preferred 11mm.
11. according to each described sling in the aforementioned claim, wherein, each end (12) are substantially sagittate, the tip outwardly, the width of the bottom of each arrow is greater than the Breadth Maximum of described middle part (10).
12. sling according to claim 11, wherein, the described base of each arrow has the width in 11 to the 16mm scopes, preferred 13.5mm, and the drift angle in 75 ° to 105 ° scopes, preferred 90 °.
13. according to each described sling in the aforementioned claim, wherein, described the first and second grids (18,20) the independently fibril by polymer form, and described polymer is selected from the group that is comprised of the homopolymer of polypropylene, polyethylene, polyester, polyamide, polymer of partly or entirely fluoridizing and composition thereof and copolymer.
14. sling according to claim 13, wherein, described fibril has the coating of biocompatible materials.
15. according to each described sling in the aforementioned claim, wherein, described the second grid (20) only covers the one side of each end of described the first grid (18), and described reverse side is not capped.
CN201180020059.1A 2010-04-19 2011-04-19 For the minimally-invasive sling of surgical treatment of female stress incontinence Expired - Fee Related CN102883679B (en)

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Application Number Priority Date Filing Date Title
ITTO2010A000314A IT1399972B1 (en) 2010-04-19 2010-04-19 MININVASIVE WANDER FOR THE SURGICAL TREATMENT OF FEMININE URINARY INCONTINENCE FROM EFFORT
ITTO2010A000314 2010-04-19
PCT/IB2011/051686 WO2011132141A1 (en) 2010-04-19 2011-04-19 Minimally invasive sling for the surgical treatment of female urinary stress incontinence

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CN102883679A true CN102883679A (en) 2013-01-16
CN102883679B CN102883679B (en) 2015-09-09

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EP (1) EP2560574B1 (en)
KR (1) KR101785135B1 (en)
CN (1) CN102883679B (en)
BR (1) BR112012025745B1 (en)
IT (1) IT1399972B1 (en)
PL (1) PL2560574T3 (en)
WO (1) WO2011132141A1 (en)

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CN107106313A (en) * 2015-03-06 2017-08-29 杜在均 The sling performed the operation for the urinary incontinence

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BR112012025745A2 (en) 2016-06-28
CN102883679B (en) 2015-09-09
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ITTO20100314A1 (en) 2011-10-20
EP2560574A1 (en) 2013-02-27

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